Why the study?
The role of proteasome adaptation and its implications in viral myocarditis are important given the challenges of cardiotoxicity and immune-related adverse effects associated with proteasome inhibition.
This review highlights the complex role of the proteasome in viral myocarditis and the potential, albeit challenging due to cardiotoxicity, of targeting it therapeutically.
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Immune mechanisms drive viral myocarditis damage; leaves open the relative role of autoimmunity versus direct viral effects.
Viral myocarditis is an inflammation of the heart muscle triggered by direct virus-induced cytolysis and immune response mechanisms with most severe consequences during early childhood. Acute and long-term manifestation of damaged heart tissue and disturbances of cardiac performance involve virus-triggered adverse activation of the immune response and both immunopathology, as well as, autoimmunity account for such immune-destructive processes. It is a matter of ongoing debate to what extent subclinical virus infection contributes to the debilitating sequela of the acute disease. In this review, we conceptualize the many functions of the proteasome in viral myocarditis and discuss the adaptation of this multi-catalytic protease complex together with its implications on the course of disease. Inhibition of proteasome function is already highly relevant as a strategy in treating various malignancies. However, cardiotoxicity and immune-related adverse effects have proven significant hurdles, representative of the target's wide-ranging functions. Thus, we further discuss the molecular details of proteasome-mediated activity of the immune response for virus-mediated inflammatory heart disease. We summarize how the spatiotemporal flexibility of the proteasome might be tackled for therapeutic purposes aiming to mitigate virus-mediated adverse activation of the immune response in the heart.
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Beling et al. (2018) studied this question.
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